Bloodborne Pathogens San Diego Unified School District Nursing & Wellness Program August 2013
Why Another In-service?? Cal/OSHA mandates that employees with occupational exposure are informed at the time of initial assignment and - At Least Annually thereafter about bloodborne Pathogens and what measures can be taken to prevent exposure
SDUSD Exposure Control Plan Written by the school district to satisfy Cal/OSHA guidelines Available on the district website Safety Office Cal/OSHA Programs Purpose is to ensure employees are aware of potential hazards related to bloodborne pathogens and how to avoid them
Objectives Identify 2 bloodborne pathogens Identify how bloodborne pathogens are and are not transmitted Identify the number one method of controlling communicable disease Identify the best way to protect yourself from Hepatitis B
Definitions Bloodborne= found in blood Pathogen = disease producing microorganism May be present in: Blood, Body fluids - semen, vaginal secretions, broken skin, saliva & vomitus (when visibly contaminated with blood)
Bloodborne Pathogens May cause infection by entering your body via: Open cuts and nicks Skin abrasions Dermatitis when skin is broken Mucous membranes mouth, eyes, nose or vagina
Hepatitis: Inflammation of the Liver Common types of Hepatitis in the US A B C D Mode of Transmission Fecal-Oral Bloodborne Bloodborne Bloodborne
What Your Liver Does Stores vitamin & minerals Makes bile to digest food Detoxifies poisonous chemicals (alcohol, drugs) Stores energy Manufactures proteins Removes inhaled poisons Makes clotting factors Helps defend body from germs
Signs & Symptoms of Hepatitis Nausea and vomiting Fatigue Loss of appetite Abdominal pain Diarrhea Yellowing of eyes and skin Dark colored urine Light colored stools
Hepatitis A Not a bloodborne pathogen Contracted by eating food or drinking liquids contaminated with human feces Hand washing after using bathroom and diaper changing Rates have declined 92% since the vaccine became available in 1995 Vaccine consists of two doses given 6 months apart
Hepatitis B Serious and sometimes fatal disease Virus can live on a dry surface for 7 days There are 500 million Hepatitis B virus particles in a single teaspoon of blood Contracting Hepatitis B increases chance of developing cirrhosis & liver cancer Vaccine is free to Category 1 and other SDUSD employees working with blood and/or body fluids on a regular basis
Hepatitis B Transmitted through blood or sexual contact Can be spread via toothbrushes and razors 100 times more infectious than HIV Estimated one million people in the United States have chronic Hepatitis B infection, with 350 million people affected worldwide
SDUSD Hepatitis B Vaccine Program Hepatitis B vaccine offers your best chance to be protected from Hepatitis B. It consists of a series of 3 doses administered usually over a six-month period Category I employees new to the district or who have not completed a consent/declination form for Hepatitis B vaccine should complete form (Instructions on form) Clinic schedule on Nursing website in the forms section and from your school nurse Contact Eileen Griffiths 858.636.4380 or egriffiths@sandi.net for a clinic appointment
District Category 1 Employees School Nurse & Health Office staff School Police Speech Pathologists Special Education staff School site secretaries/clerks who assist in the Health Office Infant Center (SEEC) and Home Health Staff Coaches, Athletic Program & Physical Education staff Custodial staff R.O.P. and Community Education Program staff Bus Transportation staff
Hepatitis C Primarily transmitted through blood-to-blood contact, though also associated with use of intranasal cocaine 4 times more prevalent than HIV 10 times more infectious than HIV 75% of people have no early symptoms Increases risk of cirrhosis, liver cancer & liver failure No vaccine available #1 reason for liver transplants in the US
HIV (Human Immunodeficiency Virus) Transmitted through blood-to-blood contact, unprotected sexual contact or mother to baby Requires direct exposure of infected blood to broken skin, mucous membranes or into the bloodstream No reported cases of transmission in the school setting No vaccine available
How HIV is NOT Transmitted Shaking hands Insect bites Eating utensils Toilets Furniture Hugging Sneezing/coughing Other casual contact that does not permit exchange of body fluids
HIV Testing Anonymous Confidential No name, no record, no fee County of San Diego: (619)296-2120 for more information Results go in your medical chart Through your private physician/provider
HIV Testing and the Law Results cannot be used to determine employability or insurability You cannot be forced to be tested It is a misdemeanor to disclose positive results without the WRITTEN consent of the individual. Consent available from school nurse (on Nursing eteams)
Communication of HIV Status in the Schools Parent and student may choose not to disclose HIV status to anyone If they tell the school nurse, but choose not to consent to disclosure to anyone else, no one else will know If they authorize disclosure, authorized people will be notified on a need-toknow basis once the diagnosis has been confirmed
Universal Precautions Precautions/guidelines appropriate for preventing the spread of ALL infectious disease Treat ALL blood and body fluids as infectious
Universal Precautions Hand washing is the number one method in controlling communicable disease Use gloves and other protective equipment when there is risk of exposure to blood or body fluids, regardless of whether you think a person is infected or not. Contaminated trash is to be disposed of in a properly labeled, plastic lined container All needles, lancets and syringes are to be disposed of in a sharps container
Personal Protective Equipment (PPE) - Gloves Wear non-latex disposable gloves Wear gloves when rendering first aid and exposed to blood/body fluids blood other than your own Wear only once Replace if torn/punctured Dispose of in properly marked container Wash hands after removing
Personal Protective Equipment (PPE) Eye Protection Eye Protection shall be worn whenever splashes, spray or spatter may be generated; and eye, nose or mouth contamination can be reasonably anticipated
Handwashing For 15-30 seconds with soap and running water Before eating, drinking, or cooking After toileting/diapering, contact with body fluids, or removing gloves
Disinfectant Household chlorine bleach a solution of 10 parts water to one part bleach Mix ¼ cup bleach in bottle filled to 1 gallon Mix fresh daily Effective against HIV, Hepatitis B & most other disease causing organisms
If you are exposed to blood on Skin Eyes Mucous Membranes Wash with non-abrasive soap & water Flush with running water for at least 15 seconds Flush with water
Post Exposure Protocol Complete a First Aid Incident Report (Appendix C -district s Exposure Control Plan) & submit it to the school secretary before the end of the day Log entry in Sharps Injury log, if applicable Within 24 hours, obtain medical evaluation and treatment at one of the district s contracted occupational health sites
Resources http://www.cdc.gov/hepatitis/ http://www.cdc.gov/hiv/ http://www.sandi.net/204510610113232207/site/default.asp http://www.sdcounty.ca.gov/hhsa/programs/phs/hiv_std_hepatitis_br anch/hiv_counseling_and_testing_services.html
In closing Nurse Please contact your school nurse with any questions about the topics covered in this in-service